Financial Efficiency Inspection of the VA Memphis Healthcare System in Tennessee

The OIG conducted this inspection to assess the stewardship and oversight of funds by the VA Memphis Healthcare System in Tennessee. This inspection assessed financial activities and administrative processes to determine whether appropriate controls and oversight were in place. These included open obligations, purchase card use, inventory and supply management, and pharmacy operations. After analyzing a judgmental sample of 20 open obligations, the team found that 10 obligations totaling approximately $11.5 million were more than 90 days past the end of the performance period, and the team could not verify whether healthcare system staff reviewed these obligations, as required. In another sample, the team found that four obligations had residual funds of $7,200 that should have been deobligated. Using a sample of 40 purchase card transactions, the team estimated that staff may have made noncompliance errors in over 18,500 transactions resulting in approximately $19.8 million in questioned costs. For inventory and supply management, the team found that training issues, inadequate staffing levels, poor oversight, and data validity issues affected the healthcare system’s stock levels. Healthcare system staff also could not provide documentation to show that required physical inventories were completed or that the chief supply chain officer reviewed the list of personnel with access to the inventory system. The team also found that the healthcare system can further improve pharmacy efficiency by adhering to inventory management best practices, such as adding scannable barcodes to shelving, increasing inventory turnover rates for “A” and “C” items in accordance with Pharmacy Benefit Management target rates, and ensuring compliance with the B09 reconciliation process. The OIG made nine recommendations to the healthcare system director to address the issues identified.